Effectiveness of EFA® (expiratory flow accelerator) technology in the prevention of aspiration pneumonia in dysphagia: clinical case in gastroesophageal junction adenocarcinoma.

Background
“Ab ingestis” pneumonia is the second most common cause of nosocomial infections in inpatients and the most common cause of death in patients with dysphagia. Early interdisciplinary rehabilitation protocols could reduce penetration-aspiration episodes.

Aim
This clinical case evaluates the effects of an expiratory flow accelerator (EFA®) device – usually aimed to manage airway secretions – in addition to usual care to prevent the penetration-aspiration (PA) risk in bedridden dysphagic low-alert patients, with ineffective cough.

Methods
We analyzed the use of expiratory flow accelerator with a protocol to prevent relapses of PA compared with traditional treatments in cooperative patients.

Conclusion
This results showed the feasibility and reliability of the EFA® to prevent PA episodes in high risk dysphagic patients and provides the framework to design a trial.

Clinical rehabilitation impact
The use of EFA® technology could be assessed and used in patients with severe acquired brain injury and ineffective cough.